AB1284 GENDER CHARACTERISTICS OF IDIOPATHIC LOBULAR PANNICULITIS
Authors: O. Egorova, G. Tarasova, A. Datsina
Journal: Annals of the Rheumatic Diseases (2022)

Background Idiopathic lobular panniculitis (ILP) (Weber-Christian disease) is the least studied disease from the group of “systemic lesions of the connective tissue” and is characterized by a multifaceted lesion of the subcutaneous adipose tissue (SAT) of organs. Objectives to compare the incidence of clinical and laboratory manifestations of ILP in patients of different sexes in the Russian cohort. Methods We examined 67 patients (9 men and 58 women) aged 20 to 76 years with an average duration of the disease 78.91 months [48; 540] with a verified diagnosis of ILP, who were observed at the V.A. Nasonova Research Institute of Rheumatology in 2010-2021. In addition to general clinical examination, determination of the titer of α-1 antitrypsin, liver fractions, amylase, lipase, trypsin, ferritin, creatine phosphokinase, leptin, TNF-α, computed tomography of the chest and pathomorphological studies of induration were carried out. Results The peak of the disease in men (55.55%) was detected at 35–45 years old, while in women (38.5%) from 50 to 60 years old. In 55.2% of women, two periods of the development of the disease were identified – from 16 to 25 in 12 patients (32.4%) and from 46 to 60 in 25 patients (67.5%). When analyzing the demographic indicators in patients with ILP, 86.3% were residents of the European part of Russia, no gender differences were found. In 3 men (33.3%) and 22 women (37.9%), ILP was diagnosed within a year. With the disease duration of 1 to 5 years, the diagnosis was confirmed in 44.4% of men and in every third woman. The duration of more than 5 years from the onset of the first symptom to the establishment of a reliable diagnosis of ILP in women was 32.7%, while in men – 11.1% (p &lt;0.03). The nodular form (Nf; 55.5%) and the mesenteric form (Mf; 33.3%) were observed somewhat more often in men than in women, with a tendency to a higher body temperature and a greater number of painful (according to VAS) indurations. In women, Nf was found in 43.1% of cases, plaque form and Mf – in 15.5% each. The infiltrative form (25.8%) was found only in women. Indurations were characterized by a subfebrile temperature, mainly with localization on the thighs (75.8%), upper limbs (51.7%) and trunk (43.1%). Later, in 31 patients (46.2%) (93.5% of them were women), a combination or transition from one form to another was detected, indicating a mixed nature of the disease. Body temperature indices in men were inversely correlated with the duration of the disease (r = –0.73; p &lt;0.05). In women, there was a significant association of an increase in body temperature with pain (according to VAS) of the nodes (p &lt;0.05), as well as with the form of the disease (p &lt;0.03). Average ESR data were higher in women (24.50 ± 15.99 mm/h). In men, a high level of CRP (46.2 ± 21.7 pg/ml) was significantly more often observed with Mf (p &lt;0.0176), which correlated with the concentration of TNF-α (r = 0.72; p &lt;0.05). Women had a 2.3 times higher leptin content than men (r = 0.46; p &lt;0.05). Pathomorphological examination of a biopsy of the skin and SAT confirmed lobular panniculitis (ILP) in all cases. Conclusion In the Russian cohort of patients, male gender is associated with a progressive course of the disease, which is the basis for prescribing immunosuppressive therapy for men with ILP at early stages of the disease. Disclosure of Interests None declared